Abstract 64 Table 1 Comparison of Pre- and Post-Implementation of NAPRC Multi-Disciplinary Quality Assurance Parameters
Rectal cancer program director and coordinator Yes Yes
A defined Rectal cancer multidisciplinary team with a lead physician member from each specialty. Established but no lead physicians appointed. Yes
Rectal cancer multidisciplinary team meetings with the attendance requirementsNo strict requirements (At least one physician of each specialty was present)
Review of diagnostic pathology (95% of previously undiagnosed, previously untreated rectal cancer patients must undergo a biopsy at the Rectal cancer program for confirmation of rectal cancer diagnosis. 60% 100%
Internal medical record review100%100%
Clinical staging before definitive treatment with CT or PET/CT scan of the chest, abdomen, and pelvis, and MRI of the pelvis MRI: 68%
CT or PET: 96%
Standardized staging reporting for MRI of the pelvis highlighting the depth of tumor penetration into the mesorectum, status of the circumferential resection margin, involvement of adjacent organs, lymph node involvement, extramural venous invasion, and relation to the anal sphincter complex. Variable.
Some MRI were interpreted by radiologists without special training on rectal specimens. Some MRIs were performed in outside institutions without a standardized format.
100% of MRIs are read by a radiologist who is a member of the Rectal Cancer Multidisciplinary Team.
100% of all the MRI reports have a standardized format containing all required elements.
CEA levels100%100%
Rectal cancer multidisciplinary team treatment planning discussion 100% 100%
Treatment evaluation and recommendation summary100%100%
Definitive treatment timing (within 60 days of patient’s initial clinical evaluation). >90%** 100%
Surgical resection and standardized operative reporting.No prior standardization protocol100%
Rectal cancer surgeries are performed by a member of the Rectal cancer multidisciplinary team.
Adequate fixation time15%100%
(48-72 hours in average)
Pathology reports (95% of the specimens are read by a pathologist who is an appointed member of the Rectal Cancer Multidisciplinary Team. Reports are completed within 2 weeks. 93% reports completed within 2 weeks 100%
Cancer summary with the pathological parameters required by the National Accreditation program 100% 100%
Multidisciplinary team post-surgical treatment outcome discussion 100% 100%
Post-surgical treatment outcome discussion summary100%100%
Adjuvant therapy after surgical resection (within 8 weeks of definitive surgical resection). ** 100
Rectal cancer program education (CAP protocols and Supplemental education materials are provided by the NAPRC)NAPRC’s supplemental education materials became available on October 2017 100%
  • **variable considering referral cases from outside institutions